Yang's Roadmap: 病人自評之醫療人員溝通能力評估工具 [問卷內容]

5個常見的病人自評之醫療人員溝通能力評估工具

Scale	dimension	Measure	Items
1.Communication Assessment Tool (CAT)	Uni-dimensional CAT measuring patient perceptions of physician performance in the area of interpersonal and communication skills. 單向度???	Ÿ 15-item ž 14 doctor-oriented items ž 1 staff-oriented item Ÿ 5-point scale ž 1 = poor ž 2 = fair ž 3 = good ž 4 = very good ž 5 = excellent Ÿ summarizing score: 75 Ÿ Percent-excellent rating Ÿ Time: 1-2 min	1. Greeted me in a way that made me feel comfortable 2. Treated me with respect 3. Showed interest in my ideas about my health 4. Understood my main health concerns 5. Paid attention to me (looked at me, listened carefully) 6. Let me talk without interruptions 7. Gave me as much information as I wanted 8. Talked in terms I could understand 9. Checked to be sure I understood everything 10. Encouraged me to ask questions 11. Involved me in decisions as much as I wanted 12. Discussed next steps, including any follow-up plans 13. Showed care and concern 14. Spent the right amount of time with me 15. Staff treated me with respect Note. Item 1, 7, 9-14 are same with MPI.
2. a modified version of the Perceived Involvement in Care Scale (M-PICS)	4 dimensional 1. Health care provider information (HCP-I) (6 item): the degree to which the HCP was perceived as controlling the information-exchange process. à Higher score indicating less controlling behavior. 2. Patient Information (PI) (5 item): the extent to which the patient sought or shared information with his/her health care provider. 3. Patient Decision Making (PDM) (4 item): patient participation in decision making during the medical visit. 4. Health care Provider Facilitation (HCP-FAC) (5 item): patients’ perceived encouragement to raise questions and discuss their medical symptoms with their HCP.	Ÿ 20-item Ÿ 5-point scale ž 1=All the time ž 5 = Never Ÿ Total score: 20-100	HCP-I (Health care provider information) – 6 items 1. My HCP doesn’t like to spend time talking about treatment options. † 2. My HCP doesn’t like it when I ask questions. † 3. My HCP focuses on just one or two topics during the medical appointment so it’s hard for me to bring up other issues or concerns that I may have. † 4. I find it hard to talk with my HCP because he/she is always in such a hurry. † 5. My HCP spends little time explaining treatment options to me. † 6. My HCP gives me a complete explanation for my medical symptoms or treatment. PI (Patient Information) – 5 items 7. I ask my HCP to explain the treatment or procedure in greater detail. 8. I ask my HCP for recommendations about my medical symptoms. 9. I usually go into great detail about my medical symptoms. 10. I ask my HCP a lot of questions about my medical symptoms. 11. My HCP asks me what I believe is causing my medical symptoms. PDM (Patient Decision Making)– 4 items 12. I express doubts about the tests or treatment that my HCP recommended. † 13. I suggest a certain kind of medical treatment to HCP. 14. I insist on a particular kind of test or treatment for my symptoms. 15. I give my opinion about the type(s) or test(s) or treatment(s) that my HCP recommended. HCP-FAC (Health care provider facilitation of patient involvement) – 5 items 16. I talk about pain symptoms regardless of my HCP’s reactions when I do so. 17. I ask questions regardless of my HCP’s reaction to them. 18. My HCP asks me whether I agree with his/her decisions. 19. My HCP encourages me to talk about personal concerns related to my symptoms 20. My HCP encourages me to give my opinion about my medical treatment. Note. † reversed items
3. Matched-pair instrument (MPI)	Bi-dimensional Separated form (Patient or doctor) 1. Process 2. Content Combined form (38 items) 1. Doctor 2. Patient	Ÿ 19-item Ÿ 5-point scale Ÿ Total score: 95/	1. Greeted me in a way that made me feel comfortable Process 2. Discussed my reason(s) for coming today 3. Encouraged me to express my thoughts concerning my health problems 4. Listened carefully to what I had to say Process 5. Understood what I had to say Process 6. If a physical examination was required for your health concerns, the doctor fully explained what was done and why Content 7. Explained the lab tests needed (e.g. blood, X-rays, ultrasound, etc) Content 8. Discussed treatment options with me 9. Gave me as much information as I wanted 10. Checked to see if the treatment plan(s) was acceptable to me Content 11. Explained medications, if any, including possible side-effects Content 12. Encouraged me to ask questions 13. Responded to my questions and concerns 14. Involved me in decisions as much as I wanted 15. Discussed next steps including any follow-up plans Content 16. Checked to be sure I understood everything 17. Showed care and concern about me as a person 18. Spent the right amount of time with me 19. Overall, I was satisfied with my visit to the doctor today Note. Item 1, 9, 12, 14-18 are same with CAT.
4. the Four Habit Patient Questionnaire (4HPQ)	Uni-dimensional The questionnaire was designed to map the occurrence of specific physician behaviour, as perceived by the patients.	Ÿ 10-item Ÿ 4-point scale ž 1=definitely yes ž 2=somewhat yes ž 3= somewhat no ž 4=definitely no Ÿ Total score: 40	Habit I: invest in the beginning 1. Did the doctor seem to know the important information about your medical history? 2. At the beginning of the visit, did the doctor meet you in a way that helped put you at ease? 3. In exploring your health concerns, did the doctor give you a good chance to express yourself in your own words? 4. Did the doctor encourage you to fully describe your health concerns? 5. Did the doctor ask about all of your health concerns rather than just focusing on the first one you mentioned? Habit II: elicit the patient’s perspective 6. Did the doctor seem interested in finding out how you thought about the health concerns? 7. Did the doctor ask about your expectations for the visit? 8. Did the doctor seem interested in finding out how your current health problems are affecting your daily life? Habit III: demonstrate empathy 9. Did you get good eye contact with the doctor? 10. Did the doctor seem sensitive to your feelings? 11. Did you feel that the doctor was interested in you as a person? 12. Did the doctor encourage you to express any emotions that you felt? 13. Did the doctor do anything to help you feel okay about whatever emotions you were feeling? 14. Did the doctor help you to understand your feelings better? Habit IV: invest in the end. 15. Did the doctor give you information that directly addressed the concerns you had expressed? 16. When the doctor gave you information, did s/he give you as much time as you needed to understand it and absorb it? 17. When the doctor gave you information, was it clear and in words you could easily understand? 18. After the doctor gave you information, did s/he make sure to find out how well you understood the information? 19. Did the doctor encourage you to be as much involved as you would like in the decisions about your health care? 20. Did the doctor check to see if the treatment plan was okay with you? 21. Did the doctor make sure if you would be able to carry out the treatment plan? 22. Toward the end of the visit, did the doctor encourage you to ask any questions? 23. Toward the end of the visit, did the doctor make clear and specific plans about what you should do as a follow-up? Note. Final version: 10 items (bold word)
5.Communication skills instruments	Bi-dimensional 1. Knowledge of communication skills 2. Application of communication skills	Ÿ 13-item Ÿ 5-point scale ž 1 = strongly disagree ž 3 = neutral ž 5 = strongly agree Ÿ Total score: 45	1.The doctor wanted to understand how patients saw things 2.The doctor usually sensed what the patient was feeling 3.The doctor just took no notice of some things that the patient felt or thought† 4.The doctor's response to the patient was so fixed that the patient didn't really get through to him/her† 5.The doctor treated patient with respect and courtesy 6.The patient was able to explain his/her problem to the doctor as fully as needed 7. The doctor explained things to the patent so that they know what may be the matter with them 8. The doctor explained what treatment tests or other follow up is going to happen 9.The doctor gave the patient opportunity to express his/her feelings or ideas in planning treatment tests or follow-up 10.The doctor gave the patient opportunity to ask questions 11.The doctor used understandable and non-technical language 12.The doctor was careful and thorough 13.The patient feels satisfied with the medical care that he/she received Note. † reversed items